Obese men with type 2 diabetes often have a lack of testosterone. If this deficiency is compensated with hormone replacement therapy, sugar metabolism also improves.

What is the blood sugar level? A drop of blood is enough for the measurement. (Image: Imago)

It’s a vicious cycle: obesity often leads to a lack of testosterone in men, and the deficit of this sex hormone, in turn, leads to a further accumulation of body fat. The extent of the bacon pads increases the risk of type 2 diabetes. It is therefore not surprising that men with such “age sugar” usually not only put on too many pounds but often also have too little testosterone in their blood. Researchers from the United States now wanted to clarify to what extent those affected benefit from hormone replacement therapy. 1 Because there are indications that their derailed sugar metabolism will then improve.

More muscles, less fat

The study doctors treated a total of 44 obese men who suffered from both “old age sugar” and testosterone deficiency for half a year with testosterone and the other half with a placebo. Paresh Dandona of the State University of New York at Buffalo and his colleagues report that hormone replacement therapy has proven to be extremely useful. The men treated with it lost an average of three kilograms of fat and gained three kilograms of muscle mass at the same time. Your insulin and fasting blood glucose levels decreased, and her insulin resistance also decreased. This is referred to as when the cells do not respond adequately to the hormone insulin and are therefore unable to absorb enough glucose for their energy needs. In order to compensate for the resulting “lack of fuel”,

In order to find out why hormone replacement therapy improved metabolism, the researchers performed blood tests and gene analyzes in their fat on their subjects. They discovered that the normalization of testosterone levels had a beneficial effect on the sugar balance in at least two ways. On the one hand, it stimulated genes that ensure that the tissue perceives the messages of insulin better, and on the other hand it suppressed genes with the opposite effect. In addition, the intake of testosterone led to a decrease in the level of several inflammatory substances in the blood. These included proteins that directly or indirectly reduce the insulin sensitivity of the cells.

Michael Zitzmann, endocrinologist and sex doctor at the University Hospital in Münster, does not consider the results of the new study to be surprising. As he says on request, however, he knows of no study that has so thoroughly illuminated the influence of testosterone replacement therapy on the sugar metabolism of diabetics. Our own investigations also showed that such treatment benefits the affected person in many ways. Firstly, it could significantly reduce the need for insulin or other antidiabetic drugs; and on the other hand, it often leads to an improvement in mood and sex life as well as an increase in bone density.

Effective only in the event of a shortage

As the internist admits, the therapy only shows such beneficial effects in diabetic men with testosterone deficiency. However, such treatment is not appropriate for diabetics without this disorder.

Another way to tackle low testosterone levels, according to Zitzmann, is to change your lifestyle. “If patients manage to lose weight with exercise programs and diets, their testosterone levels will also improve.” For many, however, it is doubly difficult to achieve this goal. Because testosterone deficiency not only hinders fat loss but also impairs motivation. Diets also lead to a particularly strong loss of muscle mass in those affected. “Hormone replacement therapy, therefore, makes sense especially for those diabetics who want to change their lifestyle,” says the endocrinologist.